2nd opinion? : Just saw a urologist... - Prostate Cancer A...

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2nd opinion?

tr305
tr305
17 Replies

Just saw a urologist. After a digital exam, he said he thought my prostate was "abnormal" and suggested that I have an ultrasound / biopsy. Should I get a second opinion or is this pretty standard procedure?

17 Replies
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YostConner

Did he do a PSA test? Usually that and the DRE together point to a biopsy unless the abnormality is patently obvious.

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tr305
tr305
in reply to YostConner

My PSA is 7, that's why I got the digital exam.

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Pj10128
Pj10128
in reply to tr305

A biopsy is the next step with a PSA of 7.

The pathologist will give it a Gleason score an hopefully it will be 6 or below

Don’t wait. The biopsy is outpatient and not a big deal.

Good luck

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YostConner
YostConner
in reply to tr305

Got it. Agree with Pj10128.

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Svnupsf
Svnupsf
in reply to tr305

Before you get a biopsy, ask for a prostate MRI and check that you're with a urologist that can do an MRI guided biopsy...not all can. The difference is that an MRI will identify any suspicious tissue locations and the urologist uses the MRI image to target the biopsy needle to those points. Without this, the needle is poking (somewhat) randomly and can easily miss small problematic nodules. To quote one of the doctors at a PCRI conference a couple years ago when asked if he would have a biopsy done without that...he was emphatic: "No!"

Also, a PSA of 7 is not that high and may be your normal level. This is why it's important to have annual physicals and monitor your PSA over time. Enlarged prostate can cause elevated PSA levels. It's a change (increase) in PSA in a relatively short time that sets off the alarm bells.

Good luck!

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NYTwin

You might ask about getting a prostate MRI which could be helpful in advance of or after a biopsy which would help to further assist in your diagnosis. Wishing you good luck there!

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tr305
tr305
in reply to NYTwin

Thanks for the recommendation

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BobJensen

I had a biopsy after the digital exam showed a nodule. They took 12 core samples. 2 of the samples contained cancer.

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tr305
tr305
in reply to BobJensen

So, are you undergoing a treatment/operation?

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BobJensen
BobJensen
in reply to tr305

I already had the surgery. The doctor removed my entire prostate.

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EdinBmore

Just echoing above advice. And, def YES to MRI fusion guided biopsy. If your uro cannot perform this procedure, find one that can. Also, ask about Prostate Health Index.

Hopefully, the PSA of 7 is the result of something other than PC. Good luck to you.

EdinBaltimore

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tr305
tr305
in reply to EdinBmore

Thanks, Ed.

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DK1347

I agree with Svnupsf, proceed with caution and don’t hesitate to get second opinions, looking back I wish I had, good luck

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JimVanHorn

My urologist used two fingers, because I asked for a second opinion! Ha, Ha.

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tr305
tr305
in reply to JimVanHorn

Ahahahaha. Very funny.

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LoveyDovey

My GS's are 3+4=7, 3+4=7 and 3+3=6 which is medium. I've consulted with 3 doctors, surgeon and radiation oncologist at the Memorial Sloan Kettering Prostate Cancer Center on 68th st. in NYC. I'm not considering surgery. My Radiation Oncology doctors recommend 2 treatments and I've chosen the High Dose Rate (HDR) Brachytherapy and MSK Precise. If you need more information about Dr's Ariel Marciscano and Daniel Gorovets, visit MSKCC.org.

mskcc.org/cancer-care/types...

I've also learned during my visit at MSKCC that they offer Trans Perineum MRI/ULTRASOUND Fusion Biopsy with I consider to be much cleaner and safer.👍

If I would have known sooner I wouldn't have done the Trans Rectal MRI/ULTRASOUND Fusion biopsy (trans fecal).👎

I hope this helps and good luck!

Dan S. 58yo

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